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  • 1.
    Berg, L
    et al.
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Göransson, K
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Östergren, J
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Interruptions in emergency department work: an observational and interview study2013In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 22, no 8, p. 656-663Article in journal (Refereed)
    Abstract [en]

    Objectiv.e Frequent interruptions are assumed to have a negative effect on healthcare clinicians’ working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments.

    Method. Totally 18 clinicians, licensed practical nurses, registered nurses and medical doctors, at two Swedish emergency departments were observed during clinical work for 2 h each. A semistructured interview was conducted directly after the observation to explore their perceptions of interruptions. Data were analysed using non-parametric statistics, and by quantitative and qualitative content analysis.

    Results. The interruption rate was 5.1 interruptions per hour. Most often the clinicians were exposed to interruptions during activities involving information exchange. Calculated as percentages of categorised performed activities, preparation of medication was the most interrupted activity (28.6%). Face-to-face interaction with a colleague was the most common way to be interrupted (51%). Most common places for interruptions to occur were the nurses’ and doctors’ stations (68%). Medical doctors were the profession interrupted most often and were more often recipients of interruptions induced by others than causing self-interruptions. Most (87%) of the interrupted activities were resumed. Clinicians often did not regard interruptions negatively. Negative perceptions were more likely when the interruptions were considered unnecessary or when they disturbed the work processes.

    Conclusions. Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.

  • 2. Berg, Lena M
    et al.
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medicine Solna, Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Djärv, Therese
    Brixey, Juliana J
    Göransson, Katarina E
    Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: a qualitative study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 27, p. 11-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.

    METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.

    RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.

    CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.

  • 3. Bjurbo, Camilla
    et al.
    Eriksson, Ulrika
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Muntlin Athlin, Åsa
    Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study2018Conference paper (Refereed)
  • 4.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Falun Hospital.
    Brixey, J. J.
    Johnson, K. D.
    Berg, L.
    Disturbance during emergency department work – A concept analysis2020In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, article id 100853Article in journal (Refereed)
  • 5.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina
    Patient safety risks in the emergency department2016Conference paper (Refereed)
  • 6.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Örebro universitet.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina E
    Physicians' and nurses' perceptions of patient safety risks in the emergency department2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 33, p. 14-19Article in journal (Refereed)
    Abstract [en]

    The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks.

    METHOD: Semi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis.

    RESULTS: The experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures.

    CONCLUSION: The results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high.

  • 7.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Göransson, Katarina
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Brixey, Julie
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Contributing factors to errors in Swedish emergency departments2015In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 23, no 2, p. 156-161Article in journal (Refereed)
    Abstract [en]

    Objective: The Emergency Department (ED) is a complex and dynamic environment, often resulting in a somewhat uncontrolled and unpredictable workload. Contributing factors to errors in health care and in the ED are largely related to communication breakdowns. Moreover, the ED work environment is predisposed to multitasking, overcrowding and interruptions. These factors are assumed to have a negative impact on patient safety. Reported errors from care providers are mainly related to diagnostic procedures in Swedish EDs. However, there is a lack of knowledge and national oversight regarding contributing factors. The aim of this study was therefore to describe contributing factors in regards to errors occurring in Swedish EDs. 

    Method: Descriptive design based on registry data from the Lex Maria database of the Swedish National Board of Health and Welfare. 

    Results: The results indicate that factors contributing to errors in Swedish EDs are multifactorial in nature. The most common contributing factor was human error followed by factors in the local ED environment and teamwork failure. 

    Conclusion: Factors contributing to ED errors were multifactorial and included both organizational and teamwork failure in which human error was implicated. To reduce errors, further research is needed to develop methods that disclose latent working conditions such as high workload and interruptions. Patient safety research needs to include understanding of human behaviour in complex organizational systems and the impact of working conditions on patient safety and quality of care.

  • 8.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Göransson, Katarina
    Östergren, Jan
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Medical errors and complaints in emergency department care in Sweden as reported by care providers, health care staff and patients: a national review2013In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 20, no 1, p. 33-38Article in journal (Refereed)
    Abstract [en]

    Objective: Despite an increase in research, there is still a lack of knowledge about patient safety in emergency departments (EDs) in many European countries. The aim of this study was therefore to describe the incidence and types of reported medical errors and complaints in ED care in Sweden.

    Methods: Data reported in 2009 were gathered from national authorities, including the National Board of Health and Welfare, the Medical Responsibility Board, the Patients Advisory Committees, and local incident-reporting systems. Data were analyzed by content analysis.

    Results: Among 428 cases reported by care providers to the National Board of Health and Welfare, 64 (15.0%) were related to ED care. As several cases contained more than one medical error, 92 errors were identified, out of which 39 (42.4%) were related to diagnostic procedures. Among the 4628 cases of complaints reported by patients to the Medical Responsibility Board, 306 (6.6%) were related to ED care. In total, 437 complaints regarding perceived medical errors were identified (several cases contained more than one error), with 189 (43.2%) pertaining to diagnostic procedures. A total of 1341 complaints about ED care were made by patients to the Patients Advisory Committees (n=21), of which 655 (48.8%) were related to care and treatment. There were 7434 medical errors reported to local incident-reporting systems at the EDs (n=45). Of these, 1450 (19.5%) referred to care and treatment.

    Conclusion: Medical errors and complaints at Swedish EDs, as reported by both patients and care providers, were related mainly to diagnostic procedures and treatments.

  • 9.
    Källberg, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Göransson, Katarina
    Östergren, Jan
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Perceptions and management of patient safety risks in the emergency department2015Conference paper (Refereed)
1 - 9 of 9
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  • de-DE
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  • nn-NO
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